Vitiligo is a disease of unknown etiology and is an autoimmune dermatological skin disease. It is characterized by the appearance of depigmented lesions and the absence of color in the hair in these areas. This occurs due to the loss of melanocytes, which are responsible for the presence of pigment on the surface of the skin. They are necessary to form a protective barrier against UV radiation and other negative environmental factors. Typically, vitiligo affects about 10% of the body and further spread of spots is reduced to zero. Sometimes vitiligo is accompanied by other diseases, such as lupus erythematosus. Scientists have proven that its presence in humans is due to genetic changes in the body's immune system. It does not pose any danger, but it develops complexes and causes discomfort associated with appearance.
Diagnosing the disease is not difficult; a thorough examination is enough. If necessary, for an accurate diagnosis, a comparison is made with other diseases of similar etiology: lichen, hypomeloanosis, etc. If we describe vitiligo based on localization, then we distinguish:
- Focal - they distinguish between focal, that is, the spots are localized in one area, segmental - the lesions are located on one part of the body along the nerve plexuses and bundles. It also affects mucous membranes and is more common among black people.
- Generalized. There are: acrofascial, vulgar and mixed types. The differences are that the first affects the limbs and face, while the second affects all skin in a chaotic manner.
- Universal – with this form of vitiligo, pigment degradation occurs throughout the body.
Causes and symptoms of vitiligo
Scientists have been studying the mechanisms of this disease for a long time, but to this day it is unknown why vitiligo originates in the human body and progresses. A lot of hypotheses have been put forward, but none has a clear justification or implementation in practice. The first question that arises in the mind of a patient with vitiligo is what kind of disease it is and how to treat it?
A general series of assumptions about the causes of vitiligo:
- Disruption of the endocrine system.
- The use of drugs that provoke the onset of the disease.
- Reduced levels of vitamins and minerals in the body.
- Genetic burden, presence of the disease in other family members.
- Concomitant autoimmune diseases.
- Diabetes mellitus, lichen, leprosy and syphilis.
- Lack of the enzyme tyrosinase.
Etiopathogenesis is associated not only with a number of possible causes; some factors can also have an impact:
- systematic nervousness and stress, psychological trauma;
- intoxication of the body;
- prolonged exposure to sunlight;
- burns of varying severity;
- chronic inflammatory process.
Symptoms of vitiligo primarily include the appearance of pinkish or white discolored areas on the skin. There is an accumulation of pigment along the edges of the lesion, which makes a sharp contrast to the lesions. Over time, the number of affected skin surfaces increases. They do not cause physical discomfort; sometimes some patients experience itching and redness. The hair in these areas also undergoes depigmentation. The first symptoms of the disease are observed before the age of 30. The resulting spots are divided into types:
- areas with a clearly defined contour, spots painted in three colors;
- areas of vitiligo consisting of four colors, with a highly pigmented border around;
- inflamed spots with raised borders;
- areas with a bluish color.
If you notice signs of this disease, you should consult a dermatologist and establish an accurate diagnosis. It has been noted that some dermatological diseases are to one degree or another similar to vitiligo, but treatment involves other therapy. Therefore, it is so important to consult a doctor in time for differential diagnosis.
The most popular questions about vitiligo
I have vitiligo, can I infect my loved ones?
Vitiligo is a manifestation of disturbances in the internal balance of the body. The disorder is not viral or bacterial, and therefore the likelihood of infection is zero.
Can tattooing be used to hide stains?
The use of tattooing and permanent makeup methods can remove the manifestations of depigmentation. But they do not guarantee the prevention of the spread of vitiligo. For camouflage, it is better to use ordinary decorative cosmetics - it can be washed off at any time in order to regularly assess the condition of the stain and the dynamics of its changes.
Is it possible to sunbathe with vitiligo?
Sun rays promote the synthesis of vitamin D, which is necessary for every person and is synthesized directly in his body. But, since the lesions do not have melanin, burns may occur in the areas where the spots form. To avoid this, you should use a cream with a high ultraviolet protection factor.
My relatives have vitiligo! Am I at risk?
Scientists have identified a pattern according to which, under the influence of identical triggers, relatives showed signs of vitiligo. However, the presence of family ties does not guarantee the development of the disorder. In order to prevent it, you can take preventive measures: regulate the level of stress, eat right, follow a daily routine and exercise.
How to diagnose vitiligo and its stage
The clinical picture of the disease is obvious, but sometimes dermatologists make mistakes when making a diagnosis. The main method is a Wood's lamp, which is a fluorescent lamp. It illuminates areas affected by vitiligo with a blue color; healthy skin has a blue glow. This method is paramount when visiting a doctor. Most often, the spots are symmetrical; the hair in the area of the spots also lacks color.
In addition to examination, laboratory indicators can help in diagnosis:
- blood test for biochemistry;
- general analysis of urine and blood;
- the presence of antibodies to thyroglobulin and thyroid peroxidase.
The disease has four stages:
- Progressive - the growth of lesions accelerates and the coverage area increases, new spots appear.
- Initial – one spot appears on the surface of the skin; depending on the type of disease, it develops into other stages.
- Stationary – the patient has a single depigmented lesion that is at rest. Over time, no growth or new formations are observed.
- Repigmentation is characteristic of spots formed during medication or therapy.
It is believed that vitiligo does not threaten human life, but we should not forget that it occurs due to disorders and functional failures in the body.
Features of vitiligo in intimate places
The disease is not contagious. There have been reported cases of transmission due to genetic predisposition only. The affected areas do not differ from healthy ones in anything except color. This also applies to situations where vitiligo develops on the human genitals. Despite the unusual variegated color, the condition of the skin remains normal, and rubbing does not cause pain. Itching and peeling are also not observed.
Self-treatment is strictly prohibited, because it can provoke a significant increase in pathological foci of depigmentation.
The lesion can be located on any part of the body. The disease develops in the genitals, passing through several stages. Initially, an inflamed area with a diameter of less than 0.5 cm forms on the skin. The tissues retain a pink tint. During this period, it is still possible to prevent vitiligo, but few people consult a doctor. Therefore, the disease progresses, turning into one of the following forms:
- Stationary. In this case, the spot becomes discolored, but stops growing in size. New areas on the body are not affected.
- Progressive. Foci of vitiligo are actively growing, new ones are constantly appearing, gradually merging into large “garlands”. In this case, vitiligo on the penis can spread to the groin area, legs and further along the body.
- Regressive. The reverse process is when bleached fabrics regain their color. Sometimes this occurs spontaneously if the provoking factor has been removed.
Vitiligo on the genitals causes the most serious harm to adolescents during puberty, when a person already has a difficult relationship with his body.
The main danger of the disease is emotional discomfort during active sexual life. At the same time, men are usually more worried about the appearance of spots on the scrotum than women who have discovered vulvar vitiligo. Psychologists believe that this fact is influenced by the cultural characteristics of the upbringing of representatives of different sexes.
Treatment methods
Everyone who has encountered this disease asks the question: how can vitiligo be treated. It is possible to improve the quality of life of sick people through the use of procedures and medications. How to treat vitiligo in adults? The pathological process slows down its development when using the following therapies:
- Laser treatment. At the initial stage of the disease with local vitiligo.
- Skin whitening makes the skin tone on the affected areas even.
- Photochemotherapy is treatment with special drugs that reduce sensitivity to ultraviolet radiation, followed by irradiation. Narrowband phototherapy with a wavelength of 311 nm is considered an effective procedure.
- Melanocytic transplantation does not guarantee a lasting effect and has contraindications and complications, such as suppuration, inflammation and tissue rejection.
- Diet. Shows results in combination with other procedures. It is necessary to include foods rich in copper, zinc and iodine in your diet.
These procedures have a positive effect on the appearance of lesions devoid of pigment and even out the tone. Good results can be achieved with local form of vitiligo. Before resorting to these procedures, it is necessary to become familiar with the possible side effects. Some of them have an aggressive effect on the body. Together with the inclusion of medications in therapy, visible results can be achieved. The goal of treatment is to slow down or completely stop the progression of the pathology, as well as repigmentation of the affected areas. Patients with vitiligo have to treat the disease systematically in order to maintain the skin condition in its proper form. According to statistics, 20% of those suffering from this disease cannot be treated for a long time. As preventive measures, it is important to avoid stress, frequently stay in the sun and avoid injury.
How to prevent serious problems
The main danger of vitiligo on the genitals is the gradual damage to healthy areas of the body. Following the instructions of the attending physician helps prevent the development of pathology. Establishing metabolism, strengthening the immune system and improving mental health remain the best methods of prevention. But it is also recommended to carefully monitor hygiene and avoid direct exposure to sunlight, protecting yourself with creams.
Separately, it is worth paying attention to a person’s attitude towards vitiligo. The perception of white spots as one’s own shortcoming creates psychological problems, worsening the quality of sexual life. If symptoms appear in adolescence, it is worth paying attention to the formation of positive self-esteem and a positive perception of discolored areas. A psychologist or psychotherapist will help with this.
Drugs for the treatment of vitiligo
Without proper treatment, the disease will progress, so it is important to consult a doctor promptly when the first signs appear. Pharmacology presents a large selection of drugs aimed at restoring skin pigment. A dermatologist will tell you what to do to get rid of vitiligo, how to treat it and plan therapy correctly.
Doctors often prescribe drugs aimed at photosensitization; they reduce sensitivity to ultraviolet radiation and make it possible to comfortably carry out the procedure for irradiation with UV rays.
These include Oksoralen, the active ingredient Methoxalen, enhances melanogenesis and reduces the rate of proliferation of epidermal cells. This drug is used in the treatment of adults and children over 12 years of age. It has a number of contraindications that must be familiarized with before use.
Among the popular drugs is Phenylalanine. This is an essential amino acid that helps regulate the synthesis of melanin, which, in turn, is responsible for the production of pigment. Creams, ointments and capsules containing L-phenylalanine effectively fight vitiligo in combination with copper and zinc.
The mechanism of development of vitiligo
Vitiligo develops as a result of damage to the secretory function or disappearance (death) of melanocytes in the skin. Melanocytes, process cells with well-developed organelles and melanin granules, are located among the cells of the basal layer. The length of some processes reaches 100 microns. They are closely adjacent to the pole of keratinocytes. Melanocytes, with the help of processes, connecting with keratinocytes, form the structural and functional unit “epidermal-melanin unit of the epidermis”. Almost every cell of the basal layer is in contact with a melanocyte process, and there is also contact between melanocyte processes. There are on average up to 1200 melanocytes per 1 square cm; 1 melanocyte provides pigment to up to 36 keratinocytes. In different areas of the skin, the number of melanocytes ranges from 5 to 10% of the total number of epidermal cells. In people with dark skin, the number of melanocytes is slightly higher than in representatives of the “white” race, but the intensity of melanin synthesis is much higher.
Modern view on the treatment of vitiligo
Can vitiligo be treated with lightening ointments or creams?
Yes, but in order to even out the color of areas with increased pigmentation, you will have to be patient.
Monobenzone ointment is used to lighten dark skin, but it must be used twice a day for six months. If the disease is severe, it may take longer. The drug has no side effects; in rare cases, it may cause irritation or redness.
The result of treatment depends on the following factors: immunity, tolerance to substances in drugs, duration of the disease, metabolism, and the condition of the body. Preparations based on herbal components often have a positive effect. For example, Vitasan cream, which contains St. John's wort, string, calendula and essential oils, evens out skin tone with regular use. Used in combination with other medical procedures. Contraindications include intolerance to the components.
Initial stage of the disease
The initial symptoms of vitiligo are most often white spots on the skin, which in most cases affect:
- areas around the mouth, nose and eyes;
- the back of the arms and legs, elbows and knees;
- buttocks and groin area.
Ill males also note the appearance of characteristic spots on the scalp.
Pigmentation can be presented as:
- Inflamed areas.
- Pigmented skin, which represents the transition from the patient to the unaffected vitiligo skin.
- Blue spots.
- Areas that have no color and appear white compared to the rest of the skin.
in the photo the initial stage of vitiligo.
Further progression of vitiligo is accompanied by the appearance of additional diseases, such as:
- Baldness.
- Psoriasis.
- Dermatitis of different types.
- Inflammation of the retina.
The gastrointestinal tract is also affected. The occurrence of diseases with a chronic form of the digestive system is a common problem associated with vitiligo. In this case, you need to first cure the skin disease, since it is this disease that becomes a damaging factor for the entire body, and only then take measures to eliminate the consequences. The blow is dealt to vital organs, for example, the kidneys with this disease begin to remove toxins worse, which can result in intoxication.
An important consequence of the appearance of symptoms of this dermatological disease is the psychological pressure caused by changes in appearance. Such a “variegated” skin color makes the sick person consider himself an unattractive person with whom few people would want to communicate. People strive to disguise damaged areas, which is fraught with even greater problems if they choose the wrong means to achieve this.
When the first signs of the disease appear, you should consult a dermatologist. It will help identify the cause and select appropriate medications for the case. The sooner the examination is completed and the diagnosis is announced, the sooner treatment will begin and its results will appear.
Such patients are strictly prohibited from contacting the sun's rays. This is explained by the fact that pigment spots are a consequence of the destruction of the melanin enzyme in the skin epithelial cells, and exposure to ultraviolet rays is detrimental to it.
